All of the following are true about fibrolamellar carcinoma of the liver except :
**Core Concept**
Fibrolamellar carcinoma (FLC) of the liver is a rare subtype of hepatocellular carcinoma (HCC), characterized by its distinct histological features and better prognosis compared to conventional HCC. FLC typically affects young adults without underlying liver disease or cirrhosis.
**Why the Correct Answer is Right**
Fibrolamellar carcinoma is known for its unique histological features, including a well-circumscribed, encapsulated tumor with a characteristic "lamellar" pattern of fibrosis. It also tends to occur in younger patients, often without underlying liver disease or cirrhosis. In contrast to conventional HCC, FLC is more likely to be resectable and has a better prognosis.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because while FLC can occur in younger patients, it is not exclusively found in this age group. FLC can occur in patients of all ages, although it is more common in young adults.
* **Option B:** This option is incorrect because FLC is not typically associated with underlying liver disease or cirrhosis. In fact, one of the distinguishing features of FLC is its occurrence in the absence of underlying liver disease.
* **Option C:** This option is incorrect because while FLC can be resectable, it is not always curable with surgery alone. Adjuvant therapies, such as chemotherapy and targeted therapies, may be necessary to improve outcomes.
**Clinical Pearl / High-Yield Fact**
Fibrolamellar carcinoma is a distinct subtype of HCC that requires a high index of suspicion in young patients without underlying liver disease. A characteristic "lamellar" pattern of fibrosis on histology is a key feature that helps distinguish FLC from conventional HCC.
**Correct Answer: D**